Dysplastic nevus (patient information)

Editor-in-Chief: C. Michael Gibson, M.S.,M.D, Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [1]

Overview

Usually, the first sign of dysplastic nevus is a change in the size, shape, color or feel of a mole. The ABCD rule can help you tell a normal mole from an abnormal mole. Dysplastic nevus can be cured only if it is diagnosed and treated early. When spreads to other parts of the body, the outlook could be very bad.

What are the symptoms of Dysplastic nevus?

Usually, the first sign of dysplastic nevus is a change in the size, shape, color or feel of a mole. The ABCD rule can help you tell whether the mole is normal or not. Moles that have any of these signs should be checked by your doctor.

• Asymmetry: It means one half of the mole does not match the other half.
• Border irregularity: The edges of the mole looks ragged, blurred, or notched.
• Color: The color over the mole is not the same and may be shades of tan, brown, or black, and sometimes patches of pink, red, blue, or white.
• Diameter: The mole is larger than about 1/4 inch, although sometimes dysplastic nevi can be smaller.
• The mole is growing or changing in shape or color

Some dysplastic nevi do not fit the "rules" above and may be hard to tell if the mole is normal or not. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

Who is at highest risk?

Clinical data has suggested that the development of melanoma is related to several factors.

• Sunlight (solar UV radiation): Too much exposure to sunlight(solar UV radiation) is thought to be the biggest risk factor for most dysplastic nevi.
• Moles: Although as a benign skin tumor, the mole increases the chance of getting dysplastic nevi, especially for people with many moles.
• Genetic factors: Epidemiological data show that Whites with fair skin, freckles, or red or blond hair have a higher risk of dysplastic nevi than other race.
• Immunosuppressive factors: Clinical surveys suggest patients treated with Immunosuppressive medicines such as transplant patients, have an increased risk of developing dysplastic nevus.
• Previous melanoma: A person with previous history of melanoma has a higher risk of getting another dysplastic nevus.
• Xeroderma pigmentosum (XP): Patients with XP are at higher risk of dysplastic nevus because they can not repair damage caused by sunlight.
• Age: Epidemiological data suggest that dysplastic nevus can be found both in old people and in younger people.
• Gender: Men have a higher chance of developing dysplastic nevus than women.

Diagnosis

Regular self-examinations are key to early detection of dysplastic nevus. Any time skin cancer is suspected, go to see a dermatologist.

• Biopsy: At first dermatologists detect skin cancer through a visual examination of the skin and mucous membranes. Then, if malignancy is suspected, a biopsy will be performed. It is the most important measure for the diagnosis of dysplastic nevus or melanoma.
• Images tests such as computed tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET) scan, ultrasound and chest-x-ray: The goal of these image tests are to help find out the extent of the dysplastic nevus and determine the stage of the disease.

When to seek urgent medical care?

Call your dermatologist if symptoms of dysplastic nevus develops.

Treatment options

Patients with dysplastic nevus have many treatment options. The selection depends on cytologic atypia. The options are surgery, radiation therapy, chemotherapy, immunotherapy , or a combination of these methods. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.

• Surgery: Surgery is the main treatment for most cases of dysplastic nevus. The aim of surgery is to remove areas of spread and help patients live longer or have a better quality of life.
• Radiation therapy may be used to treat dysplastic nevus if it can not be removed by surgery.
• Chemotherapy: The treatment is to use drugs to stop the growth of cells either by killing the cells or by stopping them from dividing. Usually, chemotherapy is useful in treating it.
• Immunotherapy: This kind of treatment helps patients's immune system to better attack the atypical cells. There are many drugs of immunotherapy used for people with advanced melanoma, such as cytokines, interferon-alpha, melanoma vaccines and so on.

Diseases with similar symptoms

• Benign junctional nevus
• Cellular blue nevus
• Basal cell carcinoma
• Sclerosing angioma
• Seborrheic keratosis

Prevention of Dysplastic nevus

The best way to lower the risk of dysplastic nevus is to avoid too much exposure to the sun and other sources of UV light. Regular self check is also important.

• Sun protection practices: Slip on a shirt, slop on sunscream, slap on a wide-brimmed hat, stay in the shade, wear sunglasses.
• Avoid other sources of UV light: Aavoidance of tanning beds and sun lamps.
• Check for abnormal moles and have them removed: Regular check for your moles and go to see your dermatologist.
• Genetic counseling and testing: If you have previous melanoma or a family history of melanoma, go to see your dermatologist for genetic counseling and testing.

What to expect (Outlook/Prognosis)?

The prognosis of melanoma depends on the following:

• The location and size
• Whether there was bleeding or ulceration at the primary site
• The patient’s general health

Resources

Medlineplus Cancer.org

Patient information

• What You Need To Know About Moles and Dysplastic Nevi - patient information booklet from cancer.gov (PDF)
• MPIP: Melanoma patients information page
• Melanoma Support Organisation (Victoria, Australia) - Ran by Melanoma Sufferers with strong links to Cancer Institutes in Victoria, Australia
• Melanoma Patients Australia
• Mikes Page - The Melanoma Resource Center
• MEL-L - Melanoma e-mail list for patients, caregivers and healthcare professionals - Supporting the Melanoma Patient since 1996